The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence-based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease-related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights-based approach to the field of clinical nutrition will contribute to the construction of a moral, political and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition.
In a population of older patients with HF, the rate of 30-day all-cause readmissions in a group of patients targeted for a pharmacy team-led postdischarge intervention was significantly lower than the all-cause readmission rate in a historical control group.
Introduction Since the implementation of the Hospital Readmission Reduction Program, health systems have been working to reduce hospital readmission rates of patients with heart failure (HF). Of these efforts, the interventions with a multidisciplinary, multicomponent approach have lowered readmission rates as well as improved patient care, patient adherence, and patient outcomes. Objectives The primary objective of this study was to determine if the addition of a pharmacist to the Transitional Care Team (TCT) would decrease the number of high‐risk HF patients readmitted to the hospital before 30 days. Secondarily, this study assessed the change in self‐reported medication adherence. Methods This study was conducted at a community teaching hospital. A retrospective chart review was performed to identify HF patients who were at high risk for readmission admitted to the hospital from May 2012 to October 2013, as the historical control group. The intervention group included high‐risk patients with HF admitted from May 2014 to October 2015, who received the pharmacist‐led intervention during hospitalization and postdischarge. The pharmacist‐led intervention comprised five components: medication reconciliation, medication cost/formulary review, medication discharge counseling, providing and educating patients regarding self‐monitoring resources and postdischarge telephone follow‐up. The 8‐item Morisky Medication Adherence Scale was used to measure patients' self‐reported medication adherence at baseline, then 30 days after discharge. Results The pharmacist‐led intervention assisted in decreasing the readmission rate from 33.7% in the historical control group to 21.3% in the intervention group with a relative risk reduction of 0.696 (confidence interval: 0.488‐0.994). There was also a significant improvement in self‐reported patient medication adherence scores. Conclusion The addition of a pharmacist to the TCT that managed HF patients was associated with a decrease in the readmission rate for patients who were at high risk of readmission and improved self‐reported patient medication adherence.
The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence‐based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease‐related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights‐based approach to the field of clinical nutrition will contribute to the construction of a moral, political, and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition.
We have previously advocated that nutritional care be raised to the level of a human right, in close relationship to two well-recognized fundamental rights: the right to food and the right to health. This article aims to analyze the implication of nutritional care as a human right for healthcare practitioners.
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